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Home My WebLink AboutSWG2023-00463 - SWG As-Built - 10/30/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2023-00463 Parcel# 22017-41-00010 Applicant Name ERIC&MELISSA AUSETH Subdivision (Name/Div/Block/Lot) Applicant Address PO BOX 1868 City, State,Zip SHELTON,WA 98584 Installer Name WORKMAN CONSTRU ON Site Address 322 E DAY SPRINGS RD Designer Name ALEX PAYSSE INSTALLATION CHECKLIST Full System Installation ❑Tank(s)Only ❑ Dralnflekl Only ❑Repair ❑Other System Type CONVENTIONAL PRESSURE Pretreatment Type >5 ft.from foundation? --- - -- ❑WA ■yes ❑ No >50ft.from wells? ---- ------------------------- ❑ e ❑ Z >50ft.from surface water? --- ----------------- -- -. ❑ ❑ FCleanout between building and tank? ------------------- ❑ ❑ O Tank baffles present? - ------------------ ❑ ■ ❑ d 24"access risers over each compartment?---------------- ❑ ® ❑ w Effluent filter installed?--------------------------. ❑ ■ ❑ CO Septic tank capacity(working) 1500 cal Manufacturer SOUND PLACEMENT SERVICES �0 D-box water level and speed levelers used? --------------- � NIA ❑yes ❑ NO 00 Man'rfold/D-box accessible from surface?-- ---------------0?2 ❑ ® ❑ QQ Check valves installed? ------ ------------- ❑ ® ❑ f Transport Line Size T' Schedule/Class SCH.40 Bedrooms installed (check one) ❑ 2 ®3 ❑4 ❑ 5 ❑6 ❑CommercieVOther 11Oft.from foundation?--- -------------- - ❑ NrA ® res NO in >100 ft.from wells?----- ------------------------ ❑ 0 ❑ W >100 ft.from surface water?------------------------ ❑ 0 ❑ X >10 ft.from potable water lines? -------------- ❑ ❑ aZ >5ft.from property lines and easements?---------------- ❑ ❑ K > 30ft.from downgradient curtain/roundation drains?---------- ❑ ® ❑ Drainfield level and observation ports present -------------- ❑ 0 ❑ ❑ Graveless chambers or F Clean gravel used? (check one) Proper cover installed over drainfield? - ❑ ® ❑ Pump tank setbacks consistent with septic tank?-- - ❑ NIA YES ❑ No Z Pump tank capacity(flood) 1500 oal Manufacturer SOUND PLACEMENT SERVICES Q 24°access riser($)and accessible from surface?------------- ❑ ❑ yAla"or Control Panel Installed? --------------------- ❑ 0 ❑ jControl Panel equipped with Timer/ETM/Counter--- -------- ❑ ❑ IL Pump installed in ® Bucket or ❑ On Block or ❑ Other IL Pump Make/Model LIBERTY 290 Floats or ❑ Transducer IL a Tank draw down 2.25 in/min Pump capacity 60 apm Squirt Height 6 ft Pump on time 1 MIN Pump off time 4 HRS Daily flow set at 360 gpd we+.aerzirsoie Mason County OSS Installation Report pg. 2 Parcel# 22017-41-00010 ABANDONMENTRECORD Were existing septic components abandoned as part of this project? ------- - ---- - -- ❑ YES 0 NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-03009 ❑ YES NO RECORD DRAWING Th.a a parmanem need...mint Ee acwraO am aesMplroe.ni ro rModaa In me naM of mamun.nc.acaNuea and Nwr.envelopment Typical Record oreMrga naln: Dr.11i a malHdd dndrandn a lame.Seplirlpdmp pane mrddin.Nmh a,,reservedonned.extend and pmpuaM m4fiinpe.Ideation W sail,wai wale,ebservarm di tbn.h,am dMr massless added pdiMa. Intbnpk4 RCgN OrmNnOa mayueete additi.al dMrya in final inardlarM appronl and related permits. 0 Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNERI ENGINEER I certify that 1 installed the system in accordance with I certify that the system has been installed in Roper- the septic design stamped'APPROVED"by Mason dance with the septic design stemped'APPROVED"by County Public Health and that any deviations shown Mason County Public Health and that any deviations here have been cleaned/approved by both the designer shown here have been clearedrapproved by both and Mason County Public Health and meet all State myself and Mason County Public Health and meet all and Mason County Codes. State and Mason County Codes I further certify that all information contained on this 1 further certify that all information contained on this form and attached Record Drawing is accurate. form and attached Record Drawing is accurate. IG. i' dl:sI' a to 13.2L1 &Ifialiture of Installer Date ��Vj Printed Name of Signals MASON COUNTY PUBLIC HEALTH The undersigned approves this Installangq al§� Record Drawing on behalf of Mason Com cL` M I Health: Sgnatun of EnWonmental Hearth Specialist Dale NkNR (Stamp,SignBtur and date) THIS FORM MAY BE SCANNED ANO AVAILABLE FOR PUBLIC VI ON THE MASON COUNTY WES SITE Waaafinfin le WETLAND "C" / \\ I I // � WETLAND "B" , SEE WETLAND REPORT / PROVIDED BY CEDAR LAND USE CONSULTING / / r OSS TANKS I & DRAINFIELDrl WETLAND "A" ACCESS / APPROVED ROAD OCj3 13cosp 0? NpppN�DJq MeA(H �/rH moo• , AT,\T AIfI LOLE W114 ll8WOR D DRAW TCY PIONEERPIONEER DIGGING, CUSTOMER: ERICAUEEH Ef HOLUi I THRU 4: Tk1T HOLE5 PARCEL;C:22017i1-00010 U33 G5L (136� 33«TILL 36 ML SEPTIC. DESIGNS ADDRESS: 322 E DAY SPRINGS RD RWTr33 RCVT536 3083EM NBF NRD. GR wvlV,,W3W5s DESIGNER: ALEX L PAYSSE JFHa 36tT M!803 F3\-36W=53 SHEET: ASBUILT SCALE P=200' mw...m.,A..�.a..,.m..aeu. I O— ------------- APPROX. WATERLINE I EXISTING AT WELL ---`J 1 I I I � I % / NOMwo OM i SEPTIC TANK PUMP TANK C/O (15000ALEA) 1 VALVE BOX 1 °�„ E 1A = 54.5' 10'+ A a ' 1B = 46.0' ° FA F 1C = 37.5' 1 D = 22.0' F 1E = 20.0' $ s 5 F 1F = 26.0' / A 0 pp a f?o c a I ASONc°°,yOCj3�1p1y `® / z PRIMARY DRAINFIEL<D�q NMFgTA( . +r '• �w 200LNFT/9'+ OC 'p3 W/ RESERVE BETWEEN CLEANOUIS AT 1 E,L K g DISTAL END ANDOB ;� u >r PORTSA55HOWN RFMRD D)AVMG CUSTOMER-' ERIC AUSETH TEST HaFS THRu 4 TEST HOLE 5. PIONEER DIGGING, INC. PARCELx.22017-4I000I0 3; Ta � SEPTIC. DESIGNS ADDRESS: 322 E DAY SPRMGS RD ROOT533 ROOTs36 3M E M><DN BENEON RD. GRWRV WA W54 DESIGNER: AM L.PAYSSE OMa-36O -IW3 FAX 36 27-2353 SHEET: ASBUILT SCALE I"=20' _�,,,..,,.,a�,�w•=,T.�µ...,,